World Kidney Day is earmarked annually on the second Thursday of March to raise awareness about the role that kidneys play in our overall health. It also drives attention to the rising kidney-related ailments across the world. And while globally, the chatter around the need to pay attention to kidneys gathers steam, we thought of sharing answers to some of the most frequently asked questions around kidney health.
Dr Vijay Kher, Chairman – Nephrology, Kidney, and Urology Institute, Medanta Hospital, has addressed these queries for HealthShots.
Swollen eyes and feet, blood, or protein in the urine (foamy urine), high blood pressure, anemia, shortness of breath, fluid retention, decreased/increased urine output, nausea, vomiting, muscle cramps, itchy and dry skin and loss of appetite are some of the signs which indicate that a person may be suffering from kidney disease.
A blood test, measuring the level of waste product (creatinine) and urine determines the extent of damage to the kidney function. Age, size, gender, and ethnicity are taken into consideration when calculating the glomerular filtration rate (eGFR-a measure of kidney function) Normal function is eGFR of > 90 ml/min. In chronic kidney disease, there is a progressive decrease in eGFR.
The other measure of kidney damage is to determine the amount of urine albumin as measured by 24 hours urine albumin or spot urine albumin creatine ratio.
Kidney disease is primarily caused due to long-term diabetes and uncontrolled high blood pressure (which has gone untreated for a long period). Few patients also get diagnosed with conditions like Glomerulonephritis, stone disease, drug-induced kidney damage, and cysts in their kidneys. The uncontrolled growth of these results in chronic kidney disease and kidney failure over time.
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If you are suffering from kidney disease, consult your kidney doctor and dietitian for your nutritional needs. One should avoid foods with high sodium content, restrict intake of high amounts of potassium.
Proteins are commonly restricted in chronic kidney patients as they may put pressure on your kidneys. However, this should be done only in patients consuming high protein In India normal population consumes lower protein (0.8 g/kg body weight) which is what patients with CKD need. We don’t recommend protein restriction in Indian patients as malnutrition is very common in CKD patients and it carries serious adverse effects in CKD Thus take adequate calories (35 kcal/ kg and protein 0.7 gm/kg body weight).
In addition, avoid consuming avocados, canned foods, whole wheat bread, brown rice, bananas, juices.
A kidney transplant is the best treatment for patients with kidney failure in terms of longevity, quality, and cost-effectiveness but can be done when there is either a deceased or living donor available. Dialysis is the other treatment option for renal failure. It can’t cure the condition but can help in improving the quality of life and extending the lifespan.
There are two types of dialysis:
* Haemodialysis is performed to remove waste and toxins from the blood with the help of an external machine.
* Peritoneal dialysis is another management option that filters the waste, by using the lining of the abdomen called the peritoneum as a filter. The latter is usually done daily by patients (after training) at home.
There are five stages of chronic kidney disease based on the glomerular filtration rate.
Stage 1: Normal or high GFR (GFR > 90 mL/min) – Kidney functions normally, but some symptoms can be subject to kidney disease
Stage 2: mild chronic kidney disease (GFR = 60-89 mL/min) – Kidney functions slowly, the signs become slightly visible
Stage 3A: moderate chronic kidney disease (GFR = 45-59 mL/min) – Moderately reduced kidney function. At this stage, your kidneys functions are reduced by half
Stage 3B: moderate chronic kidney disease (GFR = 30-44 mL/min) – Moderately reduced kidney function. At this stage, your kidneys functions are reduced by half
Stage 4: Severe chronic kidney disease (GFR = 15-29 mL/min) –
Stage 5: End stage chronic kidney disease (GFR <15 mL/min) – This is stage of kidney failure.
Urinary albumin is raised in many of these stages. A kidney transplant or dialysis is required in stage 5 when symptoms develop.
Any medications you take must pass through the kidney to filter the chemicals to enter the body. It is advisable to avoid using anti-inflammatory medications, herbal medicines, food supplements, etc. as it may put pressure on your kidney. Self-medication is not the right option if you are suffering from chronic kidney disease. Check with your nephrologist before taking any counter medicines.
One can prevent and control kidney disease by following a healthy routine that keeps your body and kidneys healthy:
* Control and monitor blood sugar and Blood pressure
* Staying physically active
* Avoiding unhealthy activities like smoking and excessive alcohol
* Avoiding stress
* Adequate sleep
* Exercise and a healthy diet with adequate vegetables and fruits
* Maintaining a proper weight
Anaemia is a disease caused by decreased red blood cells which are responsible for carrying oxygen in the body. A lack of red blood cells in the body leads to fatigue, shortness of breath, heart disease, etc. The kidneys are responsible for forming red blood cells in the body through secretion of the hormone called Erythropoietin With the persistence of Chronic Kidney Disease, the kidney becomes unable to form Erythropoietin and thud red blood cells. Therefore, there is a high chance of people with this condition suffering from anaemia.